Asylum seekers constitute a particularly vulnerable group. Not only is their physical and mental health exposed to multiple stresses, but also their access to health care in Germany is legally restricted. Up to now, there is very limited scientific literature investigating the health-outcomes of asylum seekers in Germany. The aim of this study was to provide prevalence data on the morbidity and vaccination status of asylum seekers in a medium-sized German city. We used a structured questionnaire in a cross-sectional study on 214 adult asylum seekers (182 males, 24 females, 8 unknown) in Halle, Germany, 2015. The questionnaire inquired about the respondent's self-reported physical health and vaccination status and assessed their mental health using the Hopkins-Symptom-Checklist-25 and the Harvard Trauma Questionnaire. Pain (37.9 %) and psychological illness (depression: 54.7 %, anxiety disorder: 40.2 %; post-traumatic stress disorder: 18.2 %) were the most prevalent complaints. Among asylum seekers with psychological complaints, co-morbidity was high (64.2 % had more than one psychological disease). 5.6 % of the respondents mentioned suicidal thoughts. The prevalence of chronic diseases was low. We suggest interventions to improve asylum seekers' health on two levels: first, the obligatory initial medical examination after the refugees' arrival at the reception centre should be complemented with questions related to the vaccination status and the most common complaints including pain and psychological diseases. Second, medical infrastructure should be expanded to better serve the needs of culturally and linguistically diverse patient populations, so that those screened positive can be referred for early diagnosis and treatment.

Background: The growing immigration to Germany led to more patients whose medical needs are divergent from those of the domestic population. In the field of dental health care there is a debate about how well the German health system is able to meet the resulting challenges. Data on asylum-seekers’ dental health is scarce. This work is intended to reduce this data gap. Methods: We conducted this retrospective observational study in Halle (Saale), Germany. We included all persons who were registered with the social welfare office (SWO) in 2015 and received dental treatments. From the medical records, we derived information such as complaints, diagnoses, and treatments. Results: Out of 4107 asylum-seekers, the SWO received a bill for 568 people. On average, there were 1.44 treatment cases (95%-CI: 1.34–1.55) and 2.53 contacts with the dentist per patient (95%-CI: 2.33–2.74). Among those, the majority went to the dentist because of localized (43.2%, 95%-CI: 38.7–47.7) and non-localized pain (32.0%, 95%-CI: 27.8–36.2). The most widespread diagnosis was caries (n = 469, 98.7%, 95%-CI: 97.7–99.7). Conclusion: The utilization of dental care is lower among asylum-seekers than among regularly insured patients. We assume that the low prevalence rates in our data indicate existing access barriers to the German health care system.

Background The prevalence of psychological complaints is known to be very high in populations of asylum seekers. Despite this, data on the health care system's ability to adequately meet these high-risk populations' mental health needs are scarce. This article investigates how well the German outpatient health care system is able to detect and adequately treat them.

Background Asylum seekers are a vulnerable group with special needs in health care due to their migration history and pre-, peri- and postmigratory social determinants of health. However, in Germany access to health care is restricted for asylum seekers by law and administrative regulations. Methods Using claims data generated in the billing process of health care services provided to asylum seekers, we explore their utilization of health care services in the outpatient sector. We describe the utilization of outpatient specialties, prevalences of diagnoses, prescribed drugs and other health care services, as well as total costs of health care provision. Results The estimated prevalence for visiting an ambulatory physician at least once per year was 67.5% [95%-Confidence-Interval (CI): 65.1–69.9%], with a notably higher prevalence for women than men. The diagnoses with the highest one-year prevalence were “Acute upper respiratory infections” (16.1% [14.5–18.0%]), “Abdominal and pelvic pain” (15.6% [13.9–17.4%]) and “Dorsalgia” (13.8% [12.2–15.5%]). A total of 21% of all prescriptions were for common pain killers. Women received more diagnoses across most diagnosis groups and prescribed drugs from all types than men. Less than half (45.3%) of all health care costs were generated in the outpatient sector. Conclusion The analysis of claims data held in a municipal social services office is a novel approach to gain better insight into asylum seekers’ utilization of health services on an individual level. Compared to regularly insured patients, four characteristics in health care utilization by asylum seekers were identified: low utilization of ambulatory physicians; a gender gap in almost all services, with higher utilization by women; frequent prescription of pain killers; and a low proportion of overall health care costs generated in the outpatient sector. Further research is needed to describe structural and individual factors producing these anomalies.

Vaccinations are a core element of infection control. Migrants have been reported to have low vaccination rates for many infectious diseases, including COVID-19. Still, determinants of migrants’ uptake of COVID-19 vaccinations are not sufficiently clear. The present study addresses this gap and examines the respective influence of three potential determinants: barriers to access, attitude towards vaccinations in general, and towards COVID-19 vaccines. The study uses a cross-sectional online survey among migrants in Germany. The questionnaire assessed the aforementioned determinants using standardized tools. Information on 204 individuals was available. The vaccination rate in the sample was 80%. Vaccinated as compared to unvaccinated respondents reported more often the absence of financial barriers (71% (95%CI: 64–73%) vs. 45% (95%CI: 28–63%)), short waiting times (51% (95%CI: 43–59%) vs. 22% (95%CI: 5–38%)), and the presence of a vaccination center close-by (91.5% (95%CI: 87–96%) vs. 69.7% (95%CI: 54–85%)). Concerning COVID-19 vaccine acceptance, the majority of respondents (68%) agreed that the vaccine is important. Unvaccinated respondents more often feared side effects, were convinced that the vaccine is not safe, and assumed that COVID-19 is not dangerous. Correspondingly, acceptance of vaccinations in general was higher among vaccinated respondents. In line with findings from previous studies, our survey found that all three determinants seem to influence migrants’ vaccination status while their overall vaccination rate was comparable to the general population. Hence, migration background per se does not sufficiently explain vaccine acceptance and further research is needed to identify subgroups of migrants that should be specifically addressed to increase their vaccination rate.